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目的探讨静脉补充左旋肉碱对维持性透析患者的临床疗效,寻求提高维持性透析患者生活质量的方法。方法选择2008年1月至2009年12月年我科维持性血液透析患者35例,透析龄6月以上,随机分为治疗组(18例)和对照组(17例)。治疗组每次血液透析结束时静脉注射左旋肉碱1.0g,对照组除不用左旋肉碱外其他治疗均同治疗组,治疗12周,观察患者体力、精神状态、食欲、透析中肌痉挛、低血压发生率,血红蛋白、白蛋白、血清铁蛋白水平的变化,左旋肉碱不良反应。结果治疗组患者体力、精神状态、食欲均有所改善,透析中低血压及肌痉挛发生率有所下降,血红蛋白、白蛋白和血清铁蛋白均明显升高,未发现明显不良反应。结论静脉应用左旋肉碱可明显改善维持性透析患者的营养状态,改善贫血,提高其生存质量;降低透析相关性低血压和透析中肌痉挛的发生率,提高透析的耐受性。同时血液透析患者应用左旋肉碱也是相对安全的。
Objective To investigate the clinical efficacy of intravenous L-carnitine in maintenance hemodialysis patients and to find ways to improve the quality of life in maintenance hemodialysis patients. Methods Thirty-five patients with maintenance hemodialysis from January 2008 to December 2009 were randomly divided into treatment group (n = 18) and control group (n = 17). In the treatment group, L-carnitine 1.0g was injected intravenously at the end of each hemodialysis. In the control group, other treatments except L-carnitine were the same as those in the treatment group for 12 weeks. The physical, mental state, appetite, muscle spasms in dialysis, Blood pressure, hemoglobin, albumin, serum ferritin levels, L-carnitine adverse reactions. Results The physical, mental state and appetite of the treatment group were improved. The incidence of hypotension and muscle spasm in dialysis was decreased, hemoglobin, albumin and serum ferritin were significantly increased, and no obvious adverse reactions were found. Conclusion Intravenous administration of L-carnitine can significantly improve the nutritional status of maintenance dialysis patients, improve anemia and improve their quality of life; reduce dialysis-related hypotension and dialysis in the incidence of muscle spasm and improve dialysis tolerance. At the same time hemodialysis patients with L-carnitine is relatively safe.